Active NPI
Robert Joseph McKenna Jr., M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Santa Monica, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- G39081
- Practice address
- 2121 Santa Monica Blvd
Santa Monica, CA 90404-2303 - Phone
- (310) 829-8618
- Fax
- (310) 829-8607
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | G39081 | CA | Primary |
Addresses
Primary practice location
2121 Santa Monica Blvd
Santa Monica, CA 90404-2303
Mailing address
400 S Windsor Blvd
Los Angeles, CA 90020-4714
Phone (424) 272-0337
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G390810 | Medicaid | CA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rmckenna540811@oc.providencedirect.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care CompareMerit-based Incentive Payment System (MIPS)
- Final score
- 90.42 of 100
- Quality
- 96.07
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 71.98
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G39081 | CA | MD | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Saint Johns Medical Foundation | Current | Accepting new patients | |
| Robert J. McKenna Jr. MD, a Medical Corporation | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Past | Accepting new patients |
Locations
12414 Exposition Blvd
Los Angeles, CA 90064
Phone (310) 272-7640
2121 Santa Monica Blvd
Santa Monica, CA 90404
Phone (310) 281-2024
2336 Santa Monica Blvd
Ste 204
Santa Monica, CA 90404
Phone (310) 453-4477
4101 Torrance Blvd
Torrance, CA 90503
Phone (310) 540-7676
8700 Beverly Blvd
West Hollywood, CA 90048
Phone (310) 385-3291
Interoperability endpoints
- rmckenna540811@oc.providencedirect.org
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Santa Monica, CA
- NPI 1770093734
-
- Specialist
- Los Angeles, CA
- NPI 1639222565
Thoracic Surgery (Cardiothoracic Vascular Surgery)
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618790400000",
"number": "1942210117",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 S WINDSOR BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900204714",
"telephone_number": "424-272-0337",
"fax_number": "310-861-5508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 SANTA MONICA BLVD",
"city": "SANTA MONICA",
"state": "CA",
"postal_code": "904042303",
"telephone_number": "310-829-8618",
"fax_number": "310-829-8607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENNA",
"first_name": "ROBERT",
"middle_name": "JOSEPH",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2021-04-19",
"certification_date": "2021-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "CA",
"license": "G39081",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G390810",
"state": "CA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rmckenna540811@oc.providencedirect.org",
"affiliation": "N",
"address_1": "4101 Torrance Blvd",
"city": "Torrance",
"state": "CA",
"country_code": "US",
"postal_code": "905034607",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Santa Monica, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.